The Cavewoman’s Guide to Good Health

I’m in my midtown Manhattan office, waiting as my patient struggles to describe what ails her. I know what’s coming. My psychiatry practice is filled with young women like her, who should be at the peak of vitality yet feel far from it. In time, my patient unspools her symptoms: Her mood, energy and sex drive are low; her anxiety is up. And she has no idea why.

I think I do. Most of my patients are deprived of sleep, exercise and fresh air. They’re jacked up on caffeine, sugar and prescription pills, and text loved ones more than they hug them. No wonder they feel less than human. The way they’re living—the way so many of us are living now—goes against our nature. Biologically, we modern Homo sapiens are a lot like our cavewoman ancestors: We’re animals. Primates, in fact. And we have many primal needs that get ignored. That’s why the prescription for good health may be as simple as asking, What would a cavewoman do?

1. Move Your Body

Think about our pal the cavewoman. I imagine her being active all day, gathering berries and carrying water. This was considered survival back then, but now we call it cardio. Exercise is the first remedy I suggest to my patients, and I see the benefits of that advice every single day, personally, and in my patients who manage to integrate cardio into their routines. Mounting research shows that regular exercise helps to improve brain chemistry to ward off depression. Now, I totally understand that when you’re feeling tired and crappy, you’d much rather report to your couch than to the gym. So I tell my patients to schedule three exercise sessions a week: two during the workweek and one on the weekend. Or break up your workday by going to the gym or at least walking around outside the building during lunchtime. Sounds doable, right?

2. Get Some Natural Light!

I treat a high-powered executive who spends 14-hour days in a fluorescent-lit office, followed by R and R in a shadowy bar, topped off by a cab ride home in the dark to her elevator building. She asks me earnestly, “Why do I feel so listless?”

It’s really quite simple: Human beings need sunlight. This wasn’t a problem for ladies who lived off the land way back when. Spend your days in a windowless office park, however, as many women do, and your mood, energy and well-being will almost surely take a nosedive. Insufficient levels of vitamin D, which is manufactured by your body when you’re exposed to sunlight, have been linked to conditions such as depression, chronic pain, autoimmune diseases and PMS. Ask your doctor to check your vitamin D levels; if they are low, she may recommend a supplement of 1,000 IU or more. Or take advantage of the natural benefits of summertime: Even just 10 to 15 minutes of sun exposure, without SPF, three times each week (not exactly a tough feat this time of year) is enough to produce what your body needs of vitamin D.

And the benefits of getting outside every day aren’t just about vitamin D: Remember, we’re animals. Human beings thrive in their natural habitat, which happens to be the great outdoors. A study of depressed patients showed that those who went on nature walks had improvement in their mood, tension levels and self-esteem. Also, simply having a leafy plant in your office may help you feel happier and more satisfied, according to another study. Don’t forget—you are a living, breathing creature on a living, breathing planet. Go out and walk amid the rocks and trees and call it therapy.

3. Eat Real Food

If you were a cavewoman, hungry after a long night sleeping outside, what would you eat? Foods that grow in the earth, like veggies, nuts and fruits. Nothing refined, synthetic, hydrogenated or, for that matter, even partially hydrogenated. Cavewomen didn’t live on phenylacetaldehyde dimethyl acetal (yes, that’s an actual “ingredient”), and neither should you.

A patient complained to me recently that she’s dead tired during the day—then admitted she eats mainly fast food and processed foods. I gave her my junk-in, junk-out analogy: “Your body is an engine. If you don’t give it high-grade fuel, it won’t run at top speed.” We were meant to nourish ourselves with nutrient-rich foods. A plant-based diet, plus lean meats and fish, is what will make you feel your best.

And don’t forget hydration. Drink water, and your skin will thank you, as will your kidneys and bladder. Diet soda is not very cavewomanly, nor is any chemical-laden “juice.” One last thing about “dieting”: Women aren’t meant to
be bone thin, as many of my patients strive to be. So don’t kill yourself trying to get there. Plus, guys are drawn to your body at its most natural. Some brain scans suggest that men go gaga over curves, which, after all, signify fertility.

4. Beware of Predators (Sex-Drive Predators, That is)

Perhaps the top complaint I hear from my patients is low sex drive. Many want to want sex, but rarely feel up for it. While stress, anxiety and clinical disorders are all known bedroom buzzkills, there’s something else at work here that our cavewoman ancestors didn’t have to contend with: prescription drugs. Although they can be lifesavers, certain medications can do a number on sex drive, too.

Take the Pill. A new German study found that women on hormonal birth control, including the Pill and ring, had lower levels of sexual desire and arousal than women on nonhormonal methods or none at all. One possible explanation is that the Pill lowers levels of testosterone, which is critical for a robust libido. Plus, because the Pill prevents ovulation, it also inhibits the spike in sex drive many women notice midcycle.

Another common culprit: anti\0x00depressants. Nearly 40 percent of women taking certain ones experience sexual side effects such as decreased desire and difficulty reaching orgasm. Many women I see are on the double whammy of antidepressants and oral contraceptives. Unfortunately, these women have the odds stacked against their innate desire to get it on.

What I tell my patients: The more drugs you take, the more you interfere with your body’s natural processes, including libido. My goal is to keep prescriptions to the nec\0x00essary minimum. If you suspect your birth control is hurting your sex drive, consider nonhormonal options, like a copper IUD.

As for antidepressants, if you’ve been diagnosed with major depression, or you’re being treated for bipolar disorder or schizophrenia, you need your meds. But many women who are sad or stressed out aren’t necessarily clinically depressed. Which is why I often suggest that these patients… (See #5.)

5. Accept Some Natural Moodiness

Do you think cavewomen never had crappy days? They didn’t even have indoor plumbing! It’s completely normal to experience emotional ups and downs. Many times it’s hormonal (as much as we hate to admit it when we’re PMS-ing). Also, we women can be naturally empathic and sensitive—qualities that, evolutionarily speaking, have helped us become good care\0x00takers but can make us feel distressed on behalf of others.

But in our society, there’s such a focus on always being up, productive, “happy” that I worry that we’re removing the truest parts of ourselves in the interest of fitting in and keeping up with our friends, significant others and coworkers. Always remember: If you need antidepressants, take them! And never, ever stop taking them without first talking to your doctor. But also know that there are effective nonpharmaceutical ways to help regulate your mood. In clinical research, psychotherapy has proven to be as effective as medication for mild to moderate depression. And don’t underestimate the transformative powers of a healthy lifestyle: I tell my patients that if they’re eating plants, sleeping well and doing cardio a few days a week, their mood will absolutely improve. I can guarantee it.

The point? Mother Nature knows best. Follow what comes naturally for you as a human animal and you’ll be calmer, happier, more energized—and, most important, you’ll stay off my couch.

6. Connect With Others—in Person

Most primates are inherently social beings; we tend to bond in pairs and troops. This might help explain our striving to constantly keep up with Facebook groups and total strangers on Twitter. Ironically, while Americans are more “connected” than ever, we’re also increasingly cut off from each other. We feverishly text and e-mail away, but have less and less quality face time with people we really care about. Our virtual reality is devoid of the essential primal elements of bonding, namely touch, eye contact and the processing of pheromones. Early research suggests these chemicals produced by our bodies help us communicate with other humans through scent. So I’m not surprised to read that there seems to be a relationship between excessive Internet use and depression, according to research. At least a few times a week, do your primate self a favor and have face time with your friends, your mom or even the cute guy in accounts payable you IM with all day.

7. Get Your ZZZ’s

Cavewomen needed sleep for the same reasons we do: to conserve and restore energy. OK, they may have had to outrun hyenas, lions and other predators, so we don’t need sleep for the exact same reasons. But getting a good night’s sleep—eight hours is my gold standard, but some people will need more—is critical to our twenty-first-century-woman survival, too. Many of us don’t get nearly enough sleep, and we end up using drugs, sugary foods and caffeine to
compensate. All of that takes its toll. Sleep deprivation may cause irritability, sluggishness, cognitive errors and distracted driving, and is even connected to conditions like obesity and diabetes.

To maximize sleep, I tell my patients: no caffeine after noon. Give your system enough time to metabolize your morning coffee. That afternoon Starbucks run will only make you want to pop an Ambien later. And if you think you’re doing yourself a favor by mainlining decaf, know that decaffeinated coffee actually contains some
caffeine, just less than regular. I usually advise my patients to go with herbal teas in the afternoon and evening instead.

Also, put away those computers, BlackBerrys and TV remotes at least an hour before bedtime. Staring at a glowing screen may suppress the natural production of melatonin, a hormone that’s
critical to the normal sleep-wake cycle, research shows. Pick up a book, listen to music or gently stretch instead.

8. Create Some Healthy Downtime

It’s not just sleep modern women are missing out on. My patients tell me they’re so darned busy, there’s rarely time to sit—just sit—before they have to get back to doing, doing, doing. Many young women I see are suffering from a debilitating loss of downtime, of rituals and sanctified space where they can’t be reached by colleagues, friends and family, and thus are unable to recharge their own batteries. Sitting still and emptying your mind allows you to think more clearly later on, much as cleaning your inbox of spam helps you attend to important e-mails.

We need to incorporate daily “now” time as downtime. Unplug, unwind and go play, preferably outside. Go for a jog or walk. Take a yoga class. Or try mindfulness and meditation, which focus on being present and aware, and may help reduce stress as well as improve blood pressure and cholesterol levels. (Find a mindfulness class in your area at umassmed.edu/cfm/mbsr.)

Of course, developing healthy habits when you’re stressed out and need
to blow off steam sounds easier than it often is. That’s why many of my patients tend to “unwind” and self-medicate through destructive habits. But I tell them to…

9. Party the Way Cavewomen did

At the top of the list of my patients’ damaging habits: binge \0x00drinking. While there is some evidence that drinking a little wine now and then could provide health benefits, I’m not aware of any studies that support your going out and getting smashed on Saturday night. My nine years working the night shift at Bellevue Hospital Center’s psychiatric emergency room gave me plenty of exposure to drunken behavior—trust me, there’s not much to recommend it. Binge drinking (at least four drinks in one sitting for women) can damage brain and liver cells, and contribute to sleep problems and poor eating habits, not to
mention increased risk of STDs.

In some ancient groups, altered states enhanced communal rituals and gatherings. They were infused with meaning and spirituality. We should emulate that approach, rather than use substances to numb ourselves, zone out and escape.

So instead of getting your friends together to sit on stools and drink at bars all night long, try adopting a healthy group ritual of your own, like dancing—it’s a perfectly cavewomanly thing to do. Dancing is a time-honored tradition among humans. It’s also a great way to stay in shape and potentially meet a guy.

You can imbibe in moderation; just know you don’t need to get trashed to have fun. Your primate body will thank you in the morning—and for many healthy years to come.

Julie Holland, M.D., has a psychiatry practice in New York City. She’s also the author of Weekends at Bellevue.